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It explains when sponsors may allow a parent or guardian-approved caregiver to collect meals, defines guardian and suitable caregivers, and restricts caregivers to single-family assignments unless a documented direct relationship exists. The form requires an authorized caregiver attestation, non-duplication of meals attestation, and parent/guardian signature, including SFSP/SSO contact and child lists.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/non-congregate-parent-consent-form-nutrition-department-illinois-state-board-of-education-may-2025/535356/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/non-congregate-parent-consent-form-nutrition-department-illinois-state-board-of-education-may-2025/535356.png","ImageObject",300,407,{"name":92,"@type":93},"Riley West","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-19","2026-10-10",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Who can pick up SFSP/SSO meals on a child’s behalf?","Question",{"text":112,"@type":113},"The sponsor must obtain written consent from the child’s parent or guardian. 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Sponsors must obtain written consent from a child’s parent or guardian to pick up meals on the child’s behalf. Schools/nonprofit organizations must maintain accountability, program integrity, and household confidentiality.  \nA guardian is defined as being a legal guardian or someone who has a direct caregiver relationship with a child. Persons who are principally responsible for the care of the child on the day a meal is received, such as grandparents or other individuals directly providing care to the child, are considered suitable caregivers to collect meals on the child’s behalf of the children on days when they are providing care.  \nCaregivers are restricted to a single-family assignment unless a documented direct relationship exists between the families.  \nIMPORTANT:  \nChild care providers who care for groups of unrelated children do not fall under the category of a“guardian” and cannot collect program meals on behalf of parents or guardians for children attending their child care facility or day care home. This includes sponsors or providers participating in the Child and Adult Care Food Program or other federally funded programs.  \nProgram Requirements  \nIn accordance with USDA Summer Food Service Program requirements, sponsors must ensure that meals are not duplicated. By participating, households agree not to receive meals for the same child from more than one SFSP site or sponsor for the same meal service on the same day, even if multiple meal sites are available in the area. Failure to follow this requirement may result in loss of program eligibility.  \n[www.isbe](www.isbe.net/nutrition)[.net/nutrition](www.isbe.net/nutrition)  \nILLINOIS  \nSTATE BOARD OF  \nEDUCATION  \nMay 2025  \nNon-Congregate Parent Consent Form • Nutrition Department • Illinois State Board of Education  \nPlease complete the information and return the form to:  \nName of SFSP/SSO Contact:   Name of School/Nonprofit Organization:   Address:   City:   State:   ZIP Code:   Phone Number of SFSP/SSO Contact:   Email Address of SFSP/SSO Contact:    \nChildren Participating (18 Years and Under)  \nList all children in the household who will receive meals:  \nName and age:   \nName and age:   \nName and age:   \nName and age:   \nName and age:   \nAuthorized Caregiver Attestation  \nI certify that the individual listed below has a direct caregiver relationship with my child(ren) and is responsible for their care on the day(s) meals are received. I authorize this individual to pick up SFSP/ SSO meals on behalf of my child(ren) during those times.  \nName:   Relationship to Child(ren):    \nNon-Duplication of Meals Attestation  \nI understand that multiple meal sites may operate in the area. I certify that each child listed on this form will receive only one meal per meal type (breakfast, lunch, supper, or snack) per day and will not receive duplicate meals from another Summer Food Service Program site or sponsor for the same day(s) . I understand that meals may be distributed for multiple days at one time and that this rule still applies for all days covered in the meal distribution. Failure to follow this requirement may result in loss of program eligibility.  \nNon-Congregate Parent Consent Form • Nutrition Department • Illinois State Board of Education  \nParent/Guardian Information and Signature  \nI certify that the information provided on this form is true and correct.  \nFirst and Last Name:   Address:   City:   State:   ZIP Code:   Phone Number:   Email Address (if applicable):   Signature:   Date:    \nFor SFSP/SSO Representative Use Only  \nVerified ID of Caregiver:  Yes  No  \nSFSP/SSO Representative Signature:   Date:    \nThis institutio","cbCaikeNnVZKhXQ6","https://ap.wps.com/l/cbCaikeNnVZKhXQ6","pdf",197417,"English","# Program Requirements\n## Authorized Caregiver Attestation\n## Non-Duplication of Meals Attestation\n# Parent/Guardian Information and Signature\n# SFSP/SSO Representative Use Only","[{\"question\":\"Who can pick up SFSP/SSO meals on a child’s behalf?\",\"answer\":\"The sponsor must obtain written consent from the child’s parent or guardian. The authorized individual must have a direct caregiver relationship and be responsible for the child’s care on the meal day(s).\"},{\"question\":\"What counts as a “guardian” and who is considered a suitable caregiver?\",\"answer\":\"A guardian is a legal guardian or someone with a direct caregiver relationship. Suitable caregivers include persons principally responsible for the child’s care on the day a meal is received, such as grandparents or other directly responsible caregivers.\"},{\"question\":\"What is the non-duplication requirement for meals?\",\"answer\":\"Households agree not to receive meals for the same child from more than one SFSP site or sponsor for the same meal service on the same day. Failure to follow may result in loss of program eligibility.\"}]","Non-Congregate Parent Consent Form - Nutrition Department - Illinois State Board of Education - May 2025 | PDF",1791600236]